Palpable dense and mobile subareolar tissue in the male
breast defines the presence of gynecomastia. This condition is common, being
present in 30% to 50% of healthy men. A general medical history and careful
physical examination with particular attention to features suggestive of breast
cancer often suffice for evaluation in patients without symptoms or those with
incidentally discovered breast enlargement. Men with recent-onset gynecomastia
or mastodynia need a more detailed evaluation, including selected laboratory
tests to search for an underlying cause.

Diagnosis of Gynecomastia - CauseGynecomastia affects many pubescent boys and half of all adult men. Male breast
enlargement that starts in puberty often resolves on its own, within a matter of
months, as hormone levels normalize. When it occurs in adulthood, it tends to
continue. As men age, they tend to lose testosterone and gain weight. Fat cells
produce small amounts of estrogen, which continues the male breast enlargement.
For the hypertension specialist, breast
enlargement in men provides a clue to a secondary cause of hypertension or an
adverse antihypertensive drug reaction. Hyperthyroidism, chronic renal failure,
adrenal hyperplasia or tumors, amphetamine, cyclosporine, and anabolic steroids
are secondary causes of hypertension associated with gynecomastia. Reserpine,
methyldopa, and spironolactone are older drugs associated with gynecomastia;
however, calcium antagonists (more commonly),
angiotensin-converting enzyme
inhibitors, and alpha1 blockers may also be associated with this finding. So can
SSRI drugs such as Prozac.

An Pediatr (Barc). 2014 Feb 13. Unilateral gynecomastia in
young male due to tea tree oil.

Treatment of Gynecomastia
Treatment depends on the cause and may include
observation, withdrawal of an offending drug, therapy of an underlying disease,
giving androgen or antiestrogen drugs, or plastic surgery.
Tamoxifen may be of benefit. Weight loss and exercise are key.

Gynecomastia and prostate cancer
This condition is a significant problem in men
undergoing hormonal therapy for prostate cancer. It requires prompt recognition,
evaluation and management.

Gynecomastia natural treatment questions
Q. My stepson, age 44 has a problem that stresses him out. Enlarged breasts. I
don't think it's that serious but he does. Is there any alternative supplement
that would help him?
A. We not seen seen any studies with
herbs or supplements that have
been shown to be effective for gynecomastia.

Q. I found the number of inquiries on Dr. Sahalien’s
web site about possible male breast enlargement from the use of saw palmetto
interesting due to my personal experience. About six months into the use of saw
palmetto I developed painful gynecomastia on one side. After extensive
diagnostic efforts including a mammogram and a full endocrine blood work-up
(both negative except that testosterone was on the low side of the normal
range), surgical removal was suggested by one surgeon. A second surgeon asked
about saw palmetto use and suggested discontinuing it. I did so and the problem
resolved in about 30 days. The endocrinologist asked about supplements and
specifically ruled out saw palmetto as a cause in response to my question. Since
I am not biologically trained, and this happened about six years ago, I cannot
recall the exact explanation, but the endocrinologist explained his
understanding of saw palmetto’s biological mechanisms. When I researched the
described mechanisms, it became clear to me that there was a serious academic
controversy (albeit with one view in a distinct minority) about the mechanisms.
Without fully understanding the debate, I understood enough at the time to
understand that depending on who was right, saw palmetto could effect male
breast enlargement. In the course of my research I found a re-print of a
non-technical publication by an herbalist in the 1950’s who noted that saw
palmetto could be used for female breast enlargement and generally for female
hormonal imbalances. In light of the number of inquiries, my personal
experience, the academic dispute, and the older herbalist publication indicating
some folk wisdom on the subject, a warning about possible saw palmetto
gynecomastia side effects should be considered.

I suffer from gynecomastia and it is my understanding
that a reduction in the amount of estrogen could help combat this. What are the
side effects, if any, in the reduction or blocking of estrogen in males? By the
way, I'm a 40 year old male.
Much depends on the specific treatment or medication used to
block or reduce estrogen levels.

Do you know of any natural treatment for gynecomastia.
I have been suffering from it all my life.